Local anesthetic injection

Description

A local anesthetic doesn't help with labor pain but might be used to numb the vaginal area if you need an incision to extend the opening of the vagina (episiotomy) or repair a tear after delivery. The medication is injected into the perineum or vaginal tissue and takes effect quickly.

Pros

Local anesthetics temporarily numb a specific area. Negative effects for mother or baby are rare.

Cons

Local anesthetics don't relieve the pain of contractions. An allergic reaction is possible. Rarely, injecting the medication into a vein might decrease your blood pressure.

Pudendal block

Description

A pudendal block might be used shortly before delivery to block pain between the vagina and anus (perineum). A local anesthetic is injected into the vaginal wall and takes effect in 10 to 20 minutes.

Pros

A pudendal block relieves pain in the lower vagina and perineum for up to an hour. Negative effects for mother or baby are rare.

Cons

A pudendal block might not work or affect only one side of the perineum. An allergic reaction is possible. Rarely, a pudendal block can cause an infection at the injection site, and injecting the medication into a vein might decrease your blood pressure.

Tranquilizers

Description

Rarely, tranquilizers are used to relieve anxiety and promote rest in early labor or before a C-section. They might be injected into a muscle or given through an intravenous catheter and take effect in 10 to 20 minutes.

Pros

Tranquilizers relieve anxiety and promote relaxation for three to four hours.

Cons

Nitrous oxide

Description

Nitrous oxide — an odorless, tasteless gas — is an inhalation analgesia that can be used during labor. You administer the anesthetic gas using a hand-held face mask. Nitrous oxide takes effect within a minute. While common in the United Kingdom and Canada, this technique is rarely used in the United States.

Pros

Nitrous oxide alters pain perception. It can be used intermittently or continuously during labor. If you need to have a tear repaired after delivery, you might use nitrous oxide as a supplement to a local anesthetic. Self-administration might give you a sense of control over your pain management. If you become too drowsy, you'll be unable to continue holding the mask to your face and stop inhaling the anesthetic — a built-in safety mechanism. Nitrous oxide has little or no effect on the baby.

Frequently asked questions. Labor, delivery and postpartum care FAQ086. Pain relief during labor and delivery. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq086.pdf?dmc=1&ts=20140317T1358416691. Accessed March 17, 2014.

Anesthesia options for labor and delivery: What every expectant mother should know. American Association of Nurse Anesthetists. http://www.aana.com/forpatients/Pages/Anesthesia-Options-for-Labor-and-Delivery-What-Every-Expectant-Parent-Should-Know.aspx. Accessed March 17, 2014.

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